Cannabis vs Opioids for Chronic Pain: Which Works Better?
What Researchers Found About Chronic Pain and Cannabis
The Study at a Glance
Published
BMJ Open, 2024
Researchers
McMaster University (Canada)
Study Type
Meta-AnalysisParticipants
22,028 patients · 28-180 days
Key Finding
In this landmark comparison of 90 trials with 22,028 patients, cannabis was found to be similarly effective to opioids for chronic pain relief, but with a critical advantage: patients on cannabis were 45% less likely to stop treatment due to adverse events compared to those on opioids.
Key Finding: In this landmark comparison of 90 trials with 22,028 patients, cannabis was found to be similarly effective to opioids for chronic pain relief, but with a critical advantage: patients on cannabis were 45% less likely to stop treatment due to adverse events compared to those on opioids.
What Researchers Studied About Chronic Pain and Cannabis
The million-dollar question for chronic pain patients: Is cannabis as effective as opioids, and is it safer?
This 2024 network meta-analysis directly compared cannabis to opioids using data from 90 randomized trials—providing the first high-quality head-to-head comparison of these two pain treatments.
With the opioid crisis killing tens of thousands annually, finding equally effective alternatives with fewer risks could save lives.
How This Meta-Analysis Was Conducted
Researchers conducted a network meta-analysis—a sophisticated method that allows indirect comparisons:
• Analyzed 90 randomized clinical trials • Included 22,028 patients with chronic non-cancer pain • Compared cannabis, opioids, and placebo • Follow-up ranged from 28 to 180 days • Searched 10 major databases through March 2021 • Used GRADE to rate certainty of evidence
Chronic Pain Treatment Results
The Main Results:
- 1Cannabis and opioids showed similar pain relief (no significant difference)
- 2Cannabis resulted in 45% fewer treatment discontinuations due to side effects
- 3Both provided small improvements in physical functioning and sleep quality vs placebo
- 4Neither improved emotional, role, or social functioning
- 5Moderate certainty evidence for most comparisons
By the Numbers
| Statistic | What It Means |
|---|---|
| 90 | randomized clinical trials analyzed |
| 22,028 | patients included in the analysis |
| 45% | fewer patients stopped cannabis vs opioids due to side effects |
| Similar | pain relief between cannabis and opioids |
randomized clinical trials analyzed
patients included in the analysis
fewer patients stopped cannabis vs opioids due to side effects
pain relief between cannabis and opioids
What This Means for Chronic Pain Patients
This study answers one of the most important questions in pain management:
Key finding: Cannabis appears to work as well as opioids for chronic pain, but patients tolerate it better—45% fewer people quit cannabis due to side effects compared to opioids.
What both treatments help with: • Pain relief (small improvement) • Physical functioning (small improvement) • Sleep quality (small improvement)
What neither treatment helps with: • Emotional functioning • Social functioning • Role functioning
The safety advantage: Cannabis had significantly fewer discontinuations due to adverse events. This matters because opioids carry risks of dependence, overdose, and death that cannabis does not.
What to discuss with your doctor: If you have chronic pain and are considering opioids or looking for alternatives, this evidence suggests cannabis may provide similar relief with a better safety profile.
Quick Answers: Chronic Pain and Cannabis
Direct answers based on the findings of this study:
Research Summary: Answers are based on published peer-reviewed studies and represent research findings, not medical recommendations. Individual results may vary. Always consult a healthcare provider before making treatment decisions.
Does marijuana work as well as opioids for pain?
Yes, equally effective. A 2024 meta-analysis of 90 trials with over 22,000 patients found no significant difference in pain relief between marijuana and opioids for chronic pain, but cannabis showed fewer discontinuation rates (Busse et al., BMJ Open).
Source: Busse et al., BMJ Open, 2024 (PMID: 38171632)
Is weed safer than pain pills?
Yes, cannabis appears safer. A 2024 BMJ Open meta-analysis found patients on marijuana were 45% less likely to quit due to side effects compared to opioids. Cannabis also lacks the overdose and addiction risks of opioids.
Source: Busse et al., BMJ Open, 2024 (PMID: 38171632)
Can I switch from opioids to weed for pain?
Possibly yes—research shows cannabis provides similar pain relief with better tolerability. A 2024 analysis of 90 trials found patients tolerated cannabis better than opioids. But never stop opioids without your doctor's supervision.
Source: Busse et al., BMJ Open, 2024 (PMID: 38171632)
This is educational content, not medical advice
The research summarized here is for informational purposes only. Individual results may vary, and what works in studies may not work the same way for everyone. Always consult with a qualified healthcare provider before making changes to your treatment plan or starting medical cannabis therapy.
Important Limitations
This study has some caveats to keep in mind when interpreting the results:
- Most studies were 1-6 months—long-term comparison data limited
- Direct head-to-head trials of cannabis vs opioids are rare
- Different cannabis preparations across studies
- Chronic cancer pain was excluded
- Network meta-analysis relies on indirect comparisons
The Bottom Line on Cannabis for Chronic Pain
This landmark 2024 meta-analysis of 90 trials and over 22,000 patients provides the clearest comparison yet between cannabis and opioids for chronic pain. The verdict: they work about equally well, but cannabis has a significant safety advantage—45% fewer patients discontinued due to side effects. For chronic pain patients weighing their options, this evidence supports cannabis as a viable alternative to opioids.
Do You Qualify for Medical Marijuana?
If you're living with Chronic Pain, you may qualify for a medical marijuana card. Our licensed physicians can evaluate you from home via telehealth.
Related Research & Resources
Related Research
Condition Research
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This condition qualifies for medical marijuana in:
Source
Jeddi HM, Busse JW, Sadeghirad B, et al. "Cannabis for medical use versus opioids for chronic non-cancer pain: a systematic review and network meta-analysis of randomised clinical trials" BMJ Open. 2024. DOI: 10.1136/bmjopen-2022-068182
Important Information
Not Medical Advice: This research summary is for educational purposes only. It should not be used to diagnose, treat, cure, or prevent any disease or medical condition. Always consult a qualified healthcare provider before starting or changing any treatment.
Individual Variation: Research findings represent group averages. Your individual response to cannabis may differ based on genetics, other medications, underlying conditions, and many other factors.
Last reviewed: January 24, 2026
Important Notices
Research Summary Disclaimer
This content represents our interpretation of published scientific research for educational purposes. It should not be used to make treatment decisions without consulting a qualified healthcare provider. Individual results may vary from study findings.
FDA Notice
These statements have not been evaluated by the FDA. Cannabis is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not approved cannabis for any medical condition except specific prescription medications.
Copyright & Fair Use
Research summaries are provided under fair use (17 U.S.C. § 107) for educational purposes. We provide brief summaries with attribution, not full reproductions. All studies remain the intellectual property of their respective authors and publishers.
Data Sources
Study information sourced from PubMed®, U.S. National Library of Medicine. Inclusion does not imply endorsement by NLM, NIH, or the federal government.
For complete information, see our Terms of Use and Research Content Policy.
FAQs: Cannabis for Chronic Pain
Is cannabis as effective as opioids for pain?
Yes. A 2024 meta-analysis of 90 trials with 22,028 patients found no significant difference in pain relief between cannabis and opioids for chronic non-cancer pain. Both provided small improvements compared to placebo.
Is cannabis safer than opioids for chronic pain?
Evidence suggests better tolerability. The study found 45% fewer patients discontinued cannabis treatment due to adverse events compared to opioids. Cannabis also lacks the overdose and addiction risks associated with opioids.
Can I switch from opioids to cannabis for pain?
Possibly, with medical supervision. This study suggests cannabis may be a viable alternative, but never stop or change opioid medications without medical supervision. Work with your doctor to develop a safe transition plan.